Individual provider Active NPI

Andrew Paul Thomas Gregory, D.C., FNP-C, R.NCS.T

  • Family Nurse Practitioner
  • Vernon, CT
National Provider Identifier
1114961703
Registry record updated Jul 12, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
6561 Issued in CT
Practice address
460 Hartford Tpke
Vernon, CT 06066-4845
Phone
(860) 872-6229
NPI assigned
Jun 15, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 12, 2016

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Electroneurodiagnostic Specialist/Technologist 246ZE0600X CT
Neurology Chiropractor 111NN0400X 001133 CT
Registered Nurse 163W00000X 118083 CT
Family Nurse Practitioner 363LF0000X 6561 CT Primary

Addresses

Primary practice location

460 Hartford Tpke
Vernon, CT 06066-4845

Mailing address

460 Hartford Tpke
Vernon, CT 06066-4845
Phone (860) 872-6229

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CT
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20161003000142 CT Practitioner - Nurse Practitioner 3577455971 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Connecticut Back Center LLCGroup PAC ID 4486687340, 3 clinicians

Practice addresses (Care Compare)

460 Hartford Tpke
Suite B
Vernon, CT 06066-4847
Phone (860) 253-2714

Hospital & facility affiliations

  • Manchester Memorial Hospital Hospital, Manchester, CT, CCN 070027
  • Hartford Hospital Hospital, Hartford, CT, CCN 070025

Merit-based Incentive Payment System (MIPS)

Final score
93.25 of 100Reported as group
Quality
84.25
Promoting interoperability
100
Improvement activities
40
Cost
89.34

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
118083CTMDRegistered Nurse
1133CTMDPhysical Therapy Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Connecticut Back Center LLC CurrentSince Jul 18, 2016 Accepting new patients
Connecticut Back Center LLC CurrentSince Jul 18, 2016 Accepting new patients

Locations

34 Professional Park Rd
Storrs Mansfield, CT 06268
Phone (860) 429-2803

460 Hartford Tpke
Vernon Rockville, CT 06066
Phone (860) 872-6229

460 Hartford Tpke
Ste B
Vernon Rockville, CT 06066
Phone (860) 872-6229

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 3

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1150329600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1468281600000",
    "number": "1114961703",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "460 HARTFORD TPKE",
            "city": "VERNON",
            "state": "CT",
            "postal_code": "060664845",
            "telephone_number": "860-872-6229"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "460 HARTFORD TPKE",
            "city": "VERNON",
            "state": "CT",
            "postal_code": "060664845",
            "telephone_number": "860-872-6229"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GREGORY",
        "first_name": "ANDREW",
        "middle_name": "PAUL THOMAS",
        "name_prefix": "Dr.",
        "credential": "D.C., FNP-C, R.NCS.T",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-15",
        "last_updated": "2016-07-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "246ZE0600X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Other, Electroneurodiagnostic",
            "state": "CT",
            "license": null,
            "primary": false
        },
        {
            "code": "111NN0400X",
            "taxonomy_group": "",
            "desc": "Chiropractor, Neurology",
            "state": "CT",
            "license": "001133",
            "primary": false
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "CT",
            "license": "118083",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CT",
            "license": "6561",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Vernon, CT

Sources for this page

Verify at the official NPI Registry.